Address : ___________________

___________________________

___________________________

Date :______________________

The Assistant Vice President

MCS Limited

Shri Venkatesh Bhawan

W-40, Okhla Industrial Area, Phase-II,

New Delhi – 110 020

 

Dear Sir,

 

Reg:  Punjab National Bank Shares

 

I hereby give following information for necessary action at your end. 

 

A.  My particulars -  D-MAT FORM

PHYSICAL FORM

      Client ID No. :

Folio No.           :

      DP ID No.      :

No. of shares     :

      No. of shares  :

Certificate Nos  :                       to

 

Distinctive Nos, :                      to

 

B.  Subject (Please tick (-/) whichever is applicable)

      (    ) Fate of application

      (    ) Non receipt of Dividend/Refund Pay Order/Share certificates

      (    ) Name / Account No. etc for correction

      (    ) Change of address – New/present address is :

              (Applicable in case of physical shares) 

 

 

      (    ) Revalidation of Refund Pay Order/Dividend Warrant

      (    ) Issuance of Duplicate/New certificate in lieu of lost/damaged share certificate

      (    ) Transfer/Transmission of shares

      (    ) Others (Kindly specify)

     Relevant details of above :

 

 

 C.  Any other comments :    

 

Thanking you,

 

Yours faithfully,

 

 

(SIGNATURE)

(Name of shareholder/complainant)

 

Encl:  _____________